Fetal Hypoxia

Complete lack of, or inadequate intake of, oxygen by a baby before, during, or immediately after birth

Aetiology

Risk factors

  • Small fetus
  • Preterm/post dates
  • Antepartum haemorrhage
  • Hypertension/pre-eclampsia
  • Diabetes
  • Meconium
  • Epidural analgesia
  • VBAC
  • PROM > 24h
  • Sepsis (temperature > 38℃)
  • Induction/augmentation of labour

Investigations

Identifying fetal hypoxia

  • Doppler auscultation of fetal heart
  • Electronic fetal monitoring cardiotocograph (CTG)
    • Hypoxia is characterised by loss of accelerations, repetitive deeper and wider decelerations, rising fetal baseline heart rate, and loss of variability
  • Colour of amniotic fluid

Management

  • Change maternal position
  • IV fluids
  • Stop syntocinon
  • Scalp stimulation
  • Consider tocolysis - terbutaline 250 micrograms
  • Maternal assessment - pulse, BP, abdomen, VE
  • Consider fetal blood sampling
  • Operative delivery